MEDICARE: NE HOUSTON SMILES PC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry

General Provider Information

NPI Number	:	1871269100
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NE HOUSTON SMILES PC

Provider Business Mailing Address
First Line	:	3301 TIDWELL RD STE D
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77093-6830
Country	:	US
Telephone Number	:	832-564-1800
Fax Number	:	832-564-1806

Provider Business Practice Location Address
First Line	:	3301 TIDWELL RD STE D
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77093-6830
Country	:	US
Telephone Number	:	832-564-1800
Fax Number	:	832-564-1806

Authorized Official
Title or Position	:	OFFICE MANAGER
Name	:	JUNI GARZA
Credential	:
Telephone Number	:	832-564-1800

Provider Enumeration Date	:	08/17/2021
Last Update Date	:	08/17/2021

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Directions to “NE HOUSTON SMILES PC ” Practice Location

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